| NPI | 1376567735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301080350) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D0088320) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-12-17 |