NPI | 1548258783 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: VA 0101246979) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: MD D70246) |
207K00000X Allergy & Immunology (Licence: DC MD038548) | |
Enumeration Date | 2005-10-12 |
Last Update Date | 2018-08-24 |