| NPI | 1487644803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 37692) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35.083505) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-11-01 |