| NPI | 1073580858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 124362) |
| Additional Taxonomies | 174400000X Specialist |
| 208000000X Pediatrics (Licence: NY 124362) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2013-03-26 |