| NPI | 1801897129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD071129L) |
| Additional Taxonomies | 2080I0007X Pediatrics, Clinical & Laboratory Immunology (Licence: PA MD 071129L) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2026-02-24 |