| NPI | 1639355142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: GA 65759) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2023-03-23 |