| NPI | 1356792022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A167886) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 71380-20) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2022-08-31 |