| NPI | 1922186204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 184647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 184647) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2009-02-19 |