| NPI | 1902854334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 37184) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: OH 35079350) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-04-23 |