| NPI | 1013336874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: FL 18842) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 293053) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2022-06-06 |