| NPI | 1306837083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MI 4301061396) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MI 4301061396) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2007-08-20 |