| NPI | 1558551416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 228444) |
| Additional Taxonomies | 281PC2000X Chronic Disease Hospital, Children (Licence: NY 228444) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2019-04-17 |