NPI | 1013267285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA07617900) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: PA MD073339L) |
Enumeration Date | 2012-09-14 |
Last Update Date | 2014-03-11 |