| NPI | 1366453201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: NC 2013-02199) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME41090) |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: FL ME41090) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NC 2013-02199) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2026-07-17 |