| NPI | 1114473832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35.144382) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MI 4301117316) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2025-04-09 |