| NPI | 1043673106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: PA MT219698) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME139419) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2020-06-24 |