| NPI | 1972716223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 266686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-092344) |
| 207R00000X Internal Medicine (Licence: OH 35.092344) | |
| 207R00000X Internal Medicine (Licence: MA 266686) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 62808) | |
| 208000000X Pediatrics (Licence: OH 35.092344) | |
| 208000000X Pediatrics (Licence: OH 35-092344) | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: WI 62808) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2018-04-24 |