| NPI | 1043865017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: FL ME170277) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME170277) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TX BP10066024) | |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2025-06-04 |