| NPI | 1821237975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN MD0000042861) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX E6938) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |