| NPI | 1023225190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 75964) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: GA 75964) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-07-28 |