| NPI | 1063584290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: UT 371149-1205) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 371149-1205) | 
| Enumeration Date | 2006-11-14 | 
| Last Update Date | 2013-10-02 |