| NPI | 1992945612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: MA 253391) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 04476) |
| Enumeration Date | 2009-02-21 |
| Last Update Date | 2012-09-24 |