| NPI | 1639255896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: TX J1167) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J1167) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-01-09 |