| NPI | 1295816551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MA 236616) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WA MD00035368) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2009-08-18 |