| NPI | 1972592004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WI 70625-20) |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: IA 32733) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-10-16 |