| NPI | 1881684207 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: SC MD16033) | 
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: SC 16033) | 
| 207K00000X Allergy & Immunology (Licence: NC 35781) | |
| Enumeration Date | 2005-10-26 | 
| Last Update Date | 2023-10-31 |