| NPI | 1760631741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IA 36094) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A98776) |
| 207K00000X Allergy & Immunology (Licence: FL ME125432) | |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2016-02-01 |