| NPI | 1295849594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: MO R1G07) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-08-31 |