| NPI | 1124255328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 2016017550) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: KS 04-39073) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2026-03-03 |