| NPI | 1336221134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX V0163)  | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: HI MD13782)  | 
| 208000000X Pediatrics (Licence: TX V0163)  | |
| Enumeration Date | 2006-10-20 | 
| Last Update Date | 2024-07-02 |