| NPI | 1952373805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AL 00025205) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: AL 25205) |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2020-04-09 |