NPI | 1609811744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WA MD00046647) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D54108) |
Enumeration Date | 2006-06-20 |
Last Update Date | 2012-03-23 |