| NPI | 1740555952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MS 29167) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TN 63741) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2022-02-01 |