| NPI | 1750300406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC MMD.34454TL) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01035992) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-04-27 |