| NPI | 1811316268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: LA 304888) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 304888) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2021-07-12 |