| NPI | 1811925167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME150402) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35.121180) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2021-07-15 |