| NPI | 1295793263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 182717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 182717) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2014-09-26 |