| NPI | 1376559484 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TX P8536) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD062446L) | 
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: PA MD062446L) | |
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2014-01-02 |