| NPI | 1881617405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD052300L) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: PA MD052300L) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-04-21 |