| NPI | 1861806531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: AL MD.39086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.39086) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2020-06-09 |