| NPI | 1376509364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 122080) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 122-080) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-05-14 |