| NPI | 1407119266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: PA MD488449) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2015-00802) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35.152967) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 336628) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2025-06-11 |