| NPI | 1407906282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA04236800) |
| Additional Taxonomies | 207RA0201X Internal Medicine Allergy & Immunology (Licence: NJ 25MA04236800) |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: NJ 25MA04236800) | |
| 207KA0200X Allergy & Immunology Allergy (Licence: NJ 25MA04236800) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-05-29 |