| NPI | 1245527159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MI 4301098814) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301098814) | 
| Enumeration Date | 2011-06-30 | 
| Last Update Date | 2025-06-27 |