| NPI | 1700887312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 38332) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 38332) |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2020-06-01 |