| NPI | 1902807787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 30272) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 30272) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2011-10-19 |