| NPI | 1558616250 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35.126456)  | 
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: IN 99080699A)  | 
| Enumeration Date | 2012-07-18 | 
| Last Update Date | 2021-04-12 |