| 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 |