| NPI | 1982785895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 036123) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: AL 00021359) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2013-10-04 |