| NPI | 1427148535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MA 57092) | 
| Additional Taxonomies | 2080P0216X Pediatrics, Pediatric Rheumatology (Licence: MA 57092) | 
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2025-09-11 |