| NPI | 1215128319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL OS3141) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: FL 0S3141) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2017-03-27 |