| NPI | 1770109126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036.168457) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036.168457) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: IL 036.168457) | |
| 207R00000X Internal Medicine (Licence: IL 036.168457) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2024-06-24 |