| NPI | 1033451463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NC 2020-01107) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2013-03-24 | 
| Last Update Date | 2021-06-08 |