| NPI | 1760463400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CT 038654) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: CT 038654) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2022-04-14 |