| NPI | 1588655609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 31253) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA G89207) |
| 207K00000X Allergy & Immunology (Licence: CO DR.0054651) | |
| 207K00000X Allergy & Immunology (Licence: IL 036.159243) | |
| 207K00000X Allergy & Immunology (Licence: NJ 25MA09469100) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2023-10-30 |