| NPI | 1164839361 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MO 2022018367) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD482314) | 
| Enumeration Date | 2014-07-20 | 
| Last Update Date | 2024-10-07 |