| NPI | 1922018548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 66508)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301083611)  | 
| 208000000X Pediatrics (Licence: MN 66508)  | |
| 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MI 4301083611)  | |
| Enumeration Date | 2006-08-08 | 
| Last Update Date | 2024-01-16 |