| NPI | 1982023610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 54259) |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: KY 54259) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: UT 10424137-1205) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2025-10-23 |