| NPI | 1932139532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: VT 42-0004875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 42-0004875) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |