| NPI | 1780785204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: MI 4301072658) |
| Additional Taxonomies | 207KA0200X Allergy & Immunology Allergy (Licence: MI 4301072658) |
| 208000000X Pediatrics (Licence: MI 4301072658) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2025-09-03 |