| NPI | 1578576864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 36946) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: IA D0-04935) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-09-17 |