| NPI | 1114284015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR MD215470) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO DR.0058940) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2023-07-27 |