| NPI | 1306040134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: ND 12366) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IA MD53743) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2026-03-26 |