| NPI | 1053511097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OK 29026) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD0000045160) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2024-05-17 |