| NPI | 1134515851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CO DR.0063565) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 172961) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2026-06-04 |