| NPI | 1790872646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: PA MD437462) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01062015A) |
| 2080P0214X Pediatrics Pediatric Pulmonology (Licence: PA MD437462) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-09-13 |