| NPI | 1720279102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics Pediatric Infectious Diseases (Licence: NC 2007-01187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 220698) |
| 208000000X Pediatrics (Licence: MA 220698) | |
| 2080P0208X Pediatrics Pediatric Infectious Diseases (Licence: MA 220698) | |
| 207R00000X Internal Medicine (Licence: NC 2007-01187) | |
| 208000000X Pediatrics (Licence: NC 2007-01187) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2008-07-10 |