| NPI | 1639331226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX Q7560) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD442123) |
| 207R00000X Internal Medicine (Licence: PA MD442123) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2013-00637) | |
| 208000000X Pediatrics (Licence: NC 2013-00637) | |
| 208000000X Pediatrics (Licence: TX Q7560) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2017-03-17 |