NPI | 1497868145 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OR OR MD16160) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: WA WA MD00027120) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2016-10-27 |