| NPI | 1104002708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CO 0063378) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 53463) |
| 208000000X Pediatrics (Licence: MI 4301089894) | |
| 208000000X Pediatrics (Licence: MN 104917) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A123435) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2020-02-19 |