| NPI | 1972554954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: TX L8430) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX L8430) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2016-01-21 |