| NPI | 1568429066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO R5E99) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: KS 04-22504) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2025-12-05 |