NPI | 1912140542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: CA G12489) |
Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CA G12489) |
Enumeration Date | 2009-04-13 |
Last Update Date | 2009-04-13 |