| NPI | 1568787794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WI 54265) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 54265) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2013-08-14 |