| NPI | 1497726814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: GA 034412) |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist (Licence: 060041) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2018-03-17 |