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 |