| NPI | 1679888424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: OH 35.099893) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: OH 35.099893) |
| 208000000X Pediatrics (Licence: OH 35.099893) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2023-04-06 |