| NPI | 1972668747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: NJ 25MA0577370) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 25MA05773700) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2024-10-22 |