| NPI | 1417928318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2014-02205) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME142529) |
| 207K00000X Allergy & Immunology (Licence: MD D0088620) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2022-03-22 |