| NPI | 1700140969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX P1628) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TX P1628) |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: TX P1628) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-03-21 |