| NPI | 1588779748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: OH 35050329) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OH 35050329) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2014-04-08 |