| NPI | 1649357492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MA 40744) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 40744) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-07-09 |