| NPI | 1295899979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: DC MD12429) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DC CS8800492) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-07-21 |