NPI | 1356800619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WV 3370) |
Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: WV 3370) |
Enumeration Date | 2019-03-17 |
Last Update Date | 2025-05-19 |