| NPI | 1053809186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: DC MD049272) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MD D0102616) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2025-02-13 |