| NPI | 1396909487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 301796) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: DC md034165) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2024-12-11 |