NPI | 1659421642 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: TX E0423) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX E0423) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2007-07-08 |