NPI | 1730559600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: CA G075558) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 158767) |
Enumeration Date | 2015-10-04 |
Last Update Date | 2015-10-04 |