NPI | 1417938119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 195509) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA06007900) |
Enumeration Date | 2005-11-09 |
Last Update Date | 2023-03-07 |