| NPI | 1225489065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CA A161483) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2016021101) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-11-01 |