| NPI | 1215195318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: MA 243114) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 244421) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-02-17 |