| NPI | 1386771392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO CDRH.0040766) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WY 17069C) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2025-12-19 |