| NPI | 1992890727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA 043360) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: SC 20053) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2024-05-17 |