| NPI | 1780667139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35037406V)  | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35034706)  | 
| Enumeration Date | 2005-11-21 | 
| Last Update Date | 2008-09-08 |