NPI | 1902807902 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: PA MD014113E) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA05175900) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2015-07-13 |