| NPI | 1285734947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX K9464) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: TX K9464) |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: TX K9464) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2009-05-07 |