| NPI | 1063565067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NY 112682) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 112682) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2007-07-08 |