NPI | 1659711935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: PA MD472936) |
Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: MA 265936) |
Enumeration Date | 2013-07-01 |
Last Update Date | 2023-06-22 |