NPI | 1891787289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CA G33523) |
Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: AZ 24719) |
Enumeration Date | 2005-08-22 |
Last Update Date | 2014-06-19 |