| NPI | 1003203159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX R0725) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R0725) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2025-06-30 |