| NPI | 1205496643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MA 287083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2019021239) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2025-05-13 |