| 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 |