| NPI | 1427105394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 41014) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35.099667) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-07-11 |