| NPI | 1417140997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: LA MD.200262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.200262) |
| 208000000X Pediatrics (Licence: LA MD.200262) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: LA MD.200262) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2021-03-26 |