| NPI | 1578545836 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G60479) | 
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CA G60479) | 
| Enumeration Date | 2005-11-14 | 
| Last Update Date | 2015-04-06 |