| NPI | 1194765123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA G12838) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA G12838) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-09-16 |