| NPI | 1437599495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA A138513) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IL 036139837) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2018-06-29 |