| NPI | 1831150770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 4301050475) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: MI 4301050475) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2023-04-20 |