| NPI | 1902078066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2022-02522) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME 116755) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2023-10-30 |