| NPI | 1306042908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: FL 133607) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PR 17536) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: PR 17536) | |
| 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: PR 17536) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-03-09 |