| NPI | 1760431829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 152142) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 152142) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NY 152142) | |
| 207R00000X Internal Medicine (Licence: NY 152142) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2025-06-17 |