| NPI | 1790704203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA MD60927195) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IN 01055696A) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-05-10 |