| NPI | 1467755637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: RI MD14791) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301097170) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: RI MD14791) | |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2017-07-03 |