| NPI | 1881088011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TX R4877) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R4877) | 
| Enumeration Date | 2015-03-25 | 
| Last Update Date | 2021-03-01 |