| NPI | 1811006901 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: GA 050538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 27663) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-08-07 |