| NPI | 1205135472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 267950) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA10260000) |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2023-03-07 |