| NPI | 1639355712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD439503) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 275620) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2020-01-28 |