| NPI | 1497968366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 45401) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IN 01071200A) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-03-16 |