| NPI | 1669594974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MS 21988) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 21988) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2021-10-21 |