| NPI | 1104857895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35081866) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35081866) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-02-06 |