| NPI | 1740347202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NY 97807) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NY 97807) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2013-04-16 |