NPI | 1063032167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX W0276) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX W0276) |
Enumeration Date | 2020-04-20 |
Last Update Date | 2025-08-27 |