| NPI | 1912023565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD60021238) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DC MD038579) |
| 207K00000X Allergy & Immunology (Licence: MD D0070669) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2013-11-25 |