| NPI | 1013091586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX J4905) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TX J4905) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-11-21 |