| NPI | 1306163902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX Q9299) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 036.134423) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2021-12-03 |