| NPI | 1235321233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC MD30260) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: SC 30260) |
| 207K00000X Allergy & Immunology (Licence: NC 2011-01327) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2023-10-31 |