| NPI | 1427519412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2022-00981) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: SC 91958) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2024-07-30 |