| NPI | 1205032638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MS 29525) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: SC 36287) |
| 208D00000X General Practice (Licence: SC 36287) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2024-01-10 |