| NPI | 1790769479 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA 58554)  | 
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IN 01077810A)  | 
| Enumeration Date | 2005-12-06 | 
| Last Update Date | 2017-01-17 |