| NPI | 1740202027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 68581) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 68581) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: PA MD070749L) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2022-05-09 |