| NPI | 1447789789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 34.018079) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125070264) |
| 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 34.018079) | |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2025-09-24 |