| NPI | 1952394298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 031690) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: GA 031690) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2022-04-20 |