| NPI | 1871532184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TN MD025057) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: GA 048469) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-03-30 |