| NPI | 1578500252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 82595) |
| Additional Taxonomies | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: OH 82595) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-05-31 |