| NPI | 1578156980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NE 2694) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 2694) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2025-06-09 |