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 |