| NPI | 1467413658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: KY 43400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 43400) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2015-01-05 |