| NPI | 1831243708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ MA31872) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NJ MA31872) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |