| NPI | 1740445782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 25839) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD009978E) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2008-07-18 |