| NPI | 1811093305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA C40246) |
| Additional Taxonomies | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA C40246) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-09-11 |