| NPI | 1578839650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MA 262165) |
| Additional Taxonomies | 2080H0002X (Licence: MA 262165) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2019-05-21 |