| NPI | 1538369418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA08217500) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 236569) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2016-12-09 |