| NPI | 1558437996 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NC 2018-02690)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-02690)  | 
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OR MD224100)  | |
| Enumeration Date | 2006-11-28 | 
| Last Update Date | 2025-03-25 |