| NPI | 1699302513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: WA MD61464655) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61464655) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-06-04 |