| NPI | 1922065283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD021460E) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: PA 004627A) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2010-05-21 |