| NPI | 1477809176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 54769) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 292381) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116024521) | |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-06-30 |