| NPI | 1821194820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: CA A33713) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: CA A33713) |
| 2080P0214X Pediatrics Pediatric Pulmonology (Licence: CA A33713) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-03-17 |