| NPI | 1366474470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME99049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN 10667) |
| 208000000X Pediatrics (Licence: OH 35.87877) | |
| 208000000X Pediatrics (Licence: FL ME99049) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-03-06 |