| NPI | 1588788186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 106087) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 106087) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: NY 106087) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2011-10-04 |