| NPI | 1053639823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 62506) | 
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: WI 62506-20) | 
| Enumeration Date | 2010-05-04 | 
| Last Update Date | 2021-01-27 |