| NPI | 1699760736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 4738) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD04738) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2011-08-05 |