| NPI | 1205276458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA 155889) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 286033) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 286033) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2020-03-11 |