| NPI | 1134230709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: KY 22421) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 22421) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-11-17 |