| NPI | 1275709586 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: IA 41130) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 30133) | 
| 208000000X Pediatrics (Licence: IA 41130) | |
| 208000000X Pediatrics (Licence: AZ 81943) | |
| Enumeration Date | 2008-05-06 | 
| Last Update Date | 2018-06-01 |