| NPI | 1740867001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A195055) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: CA A195055) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-12-19 |