| NPI | 1124063730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 007718) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: KY 007718) |
| 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: VA 0202004874) | |
| 207RA0201X Internal Medicine Allergy & Immunology (Licence: VA 0202004874) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2007-07-08 |