| NPI | 1972578672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: ID M-10495) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NV 13018) |
| 207K00000X Allergy & Immunology (Licence: UT 6578473-1205) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-11-17 |