| NPI | 1225019052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA A85483) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX L7904) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-07-08 |