NPI | 1912975574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WA md00017613) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OR md10611) |
Enumeration Date | 2006-03-09 |
Last Update Date | 2009-05-07 |