| NPI | 1629078142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301407112) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: MI LH407112) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2023-10-11 |