| NPI | 1912986563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: IL 036.103331) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 036-103331) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2023-10-27 |