| NPI | 1760433247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: LA MD.15516R) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: FL ME82516) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-05-02 |