| NPI | 1013283456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: LA 326923) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 276699) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: AR E-10267) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-05-26 |