| NPI | 1932154986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MI 5315125543) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MI 4301052117) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-02-08 |