| NPI | 1881677003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO 27585) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NE 20303) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2011-11-22 |