| NPI | 1295735694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO 31974) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: KS 0427760) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-05-21 |