| NPI | 1508031956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WA MD61232104) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MT MED-PHYS-LIC-99537) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX Q0527) | |
| 208D00000X General Practice (Licence: MT MED-PHYS-LIC-99537) | |
| 208D00000X General Practice (Licence: TX Q0527) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-10-28 |