NPI | 1750743720 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD470539) |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA11492300) |
208000000X Pediatrics (Licence: PA MD470539) | |
208000000X Pediatrics (Licence: NJ 25MA11492300) | |
Enumeration Date | 2016-03-28 |
Last Update Date | 2025-03-26 |