| NPI | 1063451771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A42803) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A42803) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2012-11-27 |