| NPI | 1841404530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ 25MA08470800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08470800) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2012-09-21 |