| NPI | 1801859939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35.051349) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: OH 35051349S) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-01-07 |