| NPI | 1295996213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2009-00745) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2009-00745) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2009-00745) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2024-03-12 |