| NPI | 1992798532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L8161) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: TX L8161) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2023-08-16 |