| NPI | 1942415369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CO DR.0048242) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WY 9767A) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-10-18 |