| NPI | 1528068558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL ME151184) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WI 36091-20) |
| 207K00000X Allergy & Immunology (Licence: NH 25623) | |
| 207KA0200X Allergy & Immunology, Allergy (Licence: FL ME151184) | |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: FL ME151184) | |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2025-03-10 |