| NPI | 1205032638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: LA 342205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: SC 36287) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MS 29525) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: SC 36287) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2024-09-17 |