| NPI | 1245270230 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: AZ 17145) | 
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: AZ 17145) | 
| Enumeration Date | 2006-06-07 | 
| Last Update Date | 2011-05-12 |