| NPI | 1447205281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME111116) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: ME 016496) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-07-10 |