NPI | 1063605293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 2012-00056) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WI 51918) |
207K00000X Allergy & Immunology (Licence: KY 41230) | |
Enumeration Date | 2007-08-21 |
Last Update Date | 2012-05-16 |