NPI | 1770748378 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 162746-1) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD047417L) |
Enumeration Date | 2008-07-23 |
Last Update Date | 2018-12-28 |