| NPI | 1891136826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: NY 330108) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301102616) |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CA 141150) | |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2024-06-14 |