| NPI | 1003878943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NJ 32711) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 131535) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-07-08 |