| NPI | 1982688065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TN 58055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 58055) |
| 208000000X Pediatrics (Licence: KY 40365) | |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: KY 40365) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2019-02-28 |