| NPI | 1568683548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: OH 35.124275) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2009-00311) |
| 208000000X Pediatrics (Licence: NC 2009-00311) | |
| 208000000X Pediatrics (Licence: AL 30187) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35.124275) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2015-05-13 |