| NPI | 1104853688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME94081) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME94081) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2013-02-19 |