NPI | 1407119266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2015-00802) |
Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: PA MD488449) |
Enumeration Date | 2012-06-18 |
Last Update Date | 2025-02-12 |