| NPI | 1538184858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MB056775) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: FL OS8719) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2016-03-16 |