| NPI | 1871704627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD421039) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA09085000) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2021-02-21 |