| NPI | 1023363751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: WA MD61497710) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61497710) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2024-03-14 |