| NPI | 1861781056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA A141478) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A141478) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2024-07-31 |