| NPI | 1104385475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA A179155) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A179155) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2025-08-01 |