| NPI | 1578517009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: FL ME87944) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: FL ME87944) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2013-08-14 |