| NPI | 1053432351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX E7525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E7525) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2007-07-08 |