| NPI | 1891801528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 95169) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX M1323) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-11-02 |