| NPI | 1134129620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 37904) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IN 01057648A) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2021-03-15 |