| NPI | 1124048079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC 967) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NC 2011-01906) |
| 207K00000X Allergy & Immunology (Licence: AL DO840) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-08-16 |