| NPI | 1104916873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO 18391) |
| Additional Taxonomies | 207RI0001X Internal Medicine Clinical & Laboratory Immunology (Licence: CO 18391) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-11-12 |