| NPI | 1477612950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA04738300) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NJ 25MA04738300) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2024-05-02 |