| NPI | 1285165357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX S5700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017017626) |
| 208000000X Pediatrics (Licence: TX S5700) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2026-08-17 |