NPI | 1295231868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA A196733) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CO TL0009292) |
208000000X Pediatrics (Licence: AZ 63026) | |
Enumeration Date | 2018-04-03 |
Last Update Date | 2025-01-03 |