| NPI | 1528370764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX R9770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 58041) |
| 208000000X Pediatrics (Licence: MS 772-L) | |
| Enumeration Date | 2010-07-03 |
| Last Update Date | 2021-10-01 |