| NPI | 1528158797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 226650) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 226650) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-12-20 |