| NPI | 1972757367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics Pediatric Pulmonology (Licence: KY 44489) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY NA) |
| 208000000X Pediatrics (Licence: KY NA) | |
| 2080P0201X Pediatrics Pediatric Allergy/Immunology (Licence: KY 44489) | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2017-07-14 |