| NPI | 1174765754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: WA MD60299979) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60299979) |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2018-05-30 |