| NPI | 1215047519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080B0002X Pediatrics, Obesity Medicine (Licence: CO DR.0046009) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 46009) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-11-05 |