| NPI | 1639152846 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 038728)  | 
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CT 038728)  | 
| Enumeration Date | 2005-11-22 | 
| Last Update Date | 2015-08-27 |