| NPI | 1366931867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.150565) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: KY 59621) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2024-07-23 |