| NPI | 1407021850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: NY 251674) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 251674) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2016-08-08 |