| NPI | 1619166253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2007-01471) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TN 50417) |
| 208000000X Pediatrics (Licence: VA 0101254581) | |
| 208000000X Pediatrics (Licence: TN 50417) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: VA 0101254581) | |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2016-10-25 |