| NPI | 1265736268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NJ 25MA09622900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 262661) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 262661) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2021-07-23 |