| NPI | 1245799337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD014672E) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: PA MD014672E) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-18 |