| NPI | 1588956197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: WI 60091-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY as0799140035) |
| Enumeration Date | 2011-05-15 |
| Last Update Date | 2017-02-15 |