| NPI | 1922098250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NC 9600253) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA11349600) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-10-30 |