| NPI | 1609256205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 79229) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: MN 79229) |
| 208000000X Pediatrics (Licence: ME MD22887) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2025-10-17 |