| NPI | 1568697191 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 254401)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 254401)  | 
| Enumeration Date | 2009-05-27 | 
| Last Update Date | 2019-04-04 |