| NPI | 1548607757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TX R6227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R6227) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2025-06-06 |