| NPI | 1518949130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: PA MD-036617-E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD-036617-E) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2010-12-29 |