| NPI | 1558356402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME107986) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: IA 33418) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: IA 33418) | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: KS 04-33202) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2011-02-08 |