| NPI | 1174717276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL OS10260) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL OS10260) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2026-01-12 |