| NPI | 1073791604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2011-00847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL MD100941) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME100941) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2012-11-26 |