| NPI | 1013914019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: PR 7822) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PR 7822) |
| 208000000X Pediatrics (Licence: PR 7822) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2014-02-19 |