| NPI | 1235196452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 131109) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NJ MA33401) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2021-07-30 |