| NPI | 1336599273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2022-02032) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301110615) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-03-02 |