| NPI | 1124343108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0056333) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO 56333) |
| 208000000X Pediatrics (Licence: VT 042.0012605) | |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2018-03-17 |