| NPI | 1285768622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 158857) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 158857) | 
| Enumeration Date | 2007-03-16 | 
| Last Update Date | 2013-09-26 |