| NPI | 1255561767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 34.017658) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IN 02005087A) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2025-04-09 |