| NPI | 1285257030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 342573) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5151014445) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2026-07-16 |