| NPI | 1245590173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2014-02021) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182242) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2023-01-24 |