| NPI | 1366905846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: UT 14248699-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 4723) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2026-04-27 |