| NPI | 1922007939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD439200) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD015039E) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2020-07-07 |