| NPI | 1083778864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA G75698) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: CA G75698) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA G75698) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-03-07 |