| NPI | 1497313043 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101278185) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101278185) | 
| Enumeration Date | 2019-05-30 | 
| Last Update Date | 2024-12-09 |