| NPI | 1093863334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD023998E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA03788500) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2010-06-09 |