| NPI | 1366836587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CT 61177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 61177) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-09-08 |