| NPI | 1063582401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: CO 24593) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 24593) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2014-03-21 |