| NPI | 1487273066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO DR.0075566) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WY TL8771) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2025-07-16 |