| 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 |