| NPI | 1346507217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD455462) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT208695) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2021-06-07 |