| NPI | 1932244274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: NY 131322-1) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology, Clinical & Laboratory Immunology (Licence: NY 131322-1) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NY 131322-1) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2015-02-10 |