| NPI | 1609873660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX F2550) |
| Additional Taxonomies | 2080P0208X Pediatrics Pediatric Infectious Diseases (Licence: TX F2550) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2007-07-08 |