| NPI | 1073540076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD447274) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: MI 4301035945) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NJ 25MA08321700) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-11-08 |