| NPI | 1700014917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 14272) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 14272) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2015-03-20 |