| NPI | 1518305416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 35.132133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-9744) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2019-06-20 |