| NPI | 1316927809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX L3021) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: AZ 41557) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-09-06 |