| NPI | 1649153594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NE 17566) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 17566) |
| Enumeration Date | 2025-07-29 |
| Last Update Date | 2025-07-29 |