NPI | 1023012911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: UT 8263858-1205) |
Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: GA 037913) |
Enumeration Date | 2005-06-08 |
Last Update Date | 2015-06-03 |