| NPI | 1538721295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 2022020606) |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2022020606) |
| 208000000X Pediatrics (Licence: MO 2022020606) | |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2025-07-16 |