| NPI | 1528421781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A154645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A154645) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2025-04-28 |