| NPI | 1912921818 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NV 17547) | 
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CA A63307) | 
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2024-11-20 |