| NPI | 1912255324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: WA MD60544723) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60544723) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2018-05-07 |