| NPI | 1093394637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CO DR.0072885) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0072885) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2024-07-02 |