| NPI | 1003105768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 292193) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 60409) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: IN 01075810A) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-06-23 |