| NPI | 1669765749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: KY 04644) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TN 3162) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2020-04-10 |