| NPI | 1902854334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 37184) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 36397) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: KY 37184) | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: WV 36397) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-04-30 |