| NPI | 1164839361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: LA 201297) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD482314) |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2023-11-09 |