| NPI | 1922093624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: NY 156917) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 156917) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2013-03-26 |