| NPI | 1477549475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 216691) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 216691) |
| Enumeration Date | 2005-09-25 |
| Last Update Date | 2014-05-28 |