| NPI | 1720029218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology Allergy (Licence: TX K4676) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K4676) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-10-08 |