| NPI | 1154527000 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: OH 35092909) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35092909) | 
| Enumeration Date | 2007-06-26 | 
| Last Update Date | 2023-06-09 |