| NPI | 1982833760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WV 22154) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 22154) |
| 207R00000X Internal Medicine (Licence: WV 22154) | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2020-04-03 |