| NPI | 1205849858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: CA G69131) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NV 8888) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-08-01 |