| NPI | 1174615397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 227604) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 227604) |
| 207RA0201X Internal Medicine Allergy & Immunology (Licence: NY 227604) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: NY 227604) | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2025-03-31 |