| NPI | 1770589665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 027945) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 027945) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2013-04-18 |