| NPI | 1902912249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NJ ma58216) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ MA05821600) |
| 207KA0200X Allergy & Immunology, Allergy (Licence: NJ MA58216) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2023-05-23 |