| NPI | 1215291588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX Q4535) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10043776) |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2015-06-25 |