| NPI | 1538374335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: AL 29133) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 29133) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2007-01294) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-03-21 |