| NPI | 1609063957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 144648) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WI 56387-20) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2021-12-17 |