| NPI | 1497714984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX M3486) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35076154) |
| 207K00000X Allergy & Immunology (Licence: AL 25905) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2019-06-10 |