NPI | 1073605200 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: MT 11594) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D0062345) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2015-07-31 |