| NPI | 1154528727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: ID M13504) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 30283) |
| 208000000X Pediatrics (Licence: GA 63960) | |
| 208000000X Pediatrics (Licence: TX N8989) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX N8989) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-09-02 |