| NPI | 1710977962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC MD13617) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: SC 13617) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-10-31 |