| NPI | 1750325718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.074376) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: OH 35074376L) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2021-05-26 |