| NPI | 1306826722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2025-03239) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0101102717) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2025-11-30 |