| NPI | 1720184849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MN 49842) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A88016) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-07-15 |