| NPI | 1194302000 |
|---|---|
| Other Name | N/A N/A |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: PA OS026119) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DE C7-0018514) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2026-07-01 |