| NPI | 1306927520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 55862) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 34.007962) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WI 20911) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 106465) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2021-07-02 |