| NPI | 1295753515 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD041638L)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD041638L)  | 
| 208000000X Pediatrics (Licence: NJ 25MA07018300)  | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NJ 25MA07018300)  | |
| Enumeration Date | 2006-07-17 | 
| Last Update Date | 2013-04-18 |