| NPI | 1205931029 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX K6707) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX K6707) | 
| Enumeration Date | 2006-09-14 | 
| Last Update Date | 2012-10-05 |