| NPI | 1689606477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AK 166113) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 51624) |
| 207K00000X Allergy & Immunology (Licence: MN 45670) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-02-03 |