| NPI | 1306829940 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 022779) | 
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CT 022779) | 
| Enumeration Date | 2005-11-29 | 
| Last Update Date | 2025-09-11 |