| NPI | 1457528655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NJ 25MA08950100) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 248770) |
| 207R00000X Internal Medicine (Licence: NY 248770) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2015-04-22 |