| NPI | 1245642875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME133757) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN20217) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2021-08-20 |