| NPI | 1639566714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: GA 80574) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080S0012X Pediatrics, Sleep Medicine (Licence: GA 80574) | |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2022-07-18 |