| NPI | 1003809724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN 37132) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: KY 35810) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2024-05-14 |