| NPI | 1477520294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 175550) |
| Additional Taxonomies | 174400000X Specialist |
| 208000000X Pediatrics (Licence: NY 175550) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2015-08-18 |