| NPI | 1669464723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: TX N0209) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: CA A84051) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2023-11-28 |