| NPI | 1124474655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: PA MT227846) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A150428) |
| 208000000X Pediatrics (Licence: CA A150428) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2023-07-01 |