| NPI | 1639705528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A186308) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A186308) |
| 208000000X Pediatrics (Licence: CA PTL3720) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-07-16 |