| NPI | 1912221623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: KY 46010) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 46010) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2020-10-12 |