NPI | 1063423028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CT 035629) |
Additional Taxonomies | 174400000X Specialist (Licence: CT 035629) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2011-12-29 |