| NPI | 1316095664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD033608E) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA03977100) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2010-06-28 |