| NPI | 1649764515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics Clinical Genetics (M.D.) (Licence: PA MT215273) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT215273) |
| 2080P0205X Pediatrics Pediatric Endocrinology (Licence: PA MT215273) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2021-06-21 |