| NPI | 1326127879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ ma66911) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ ma66911) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-11-24 |