| NPI | 1588802946 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: KY 46214)  | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 46214)  | 
| 208000000X Pediatrics (Licence: KY 46214)  | |
| Enumeration Date | 2009-01-22 | 
| Last Update Date | 2015-10-07 |