| NPI | 1720059132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 32640) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-02795) |
| 208000000X Pediatrics (Licence: WI 32640) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2021-04-01 |