| NPI | 1609196013 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: VA 0101253607) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101253607) | 
| Enumeration Date | 2010-06-08 | 
| Last Update Date | 2023-08-22 |