| NPI | 1043200926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 248361) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA078857) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2013-10-16 |