| NPI | 1679586952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NY 159274) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CT 029402) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NJ 25MA06044800) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |