| NPI | 1003320185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: LA 335929) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 335929) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2023-06-02 |