| NPI | 1588680722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: TN 61834) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 101013) |
| 208000000X Pediatrics (Licence: TN 61834) | |
| 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: MO 101013) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-01-10 |