| 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 |