| NPI | 1508108119 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MA 265855)  | 
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MA 265855)  | 
| Enumeration Date | 2013-03-21 | 
| Last Update Date | 2020-07-16 |