| NPI | 1679985519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: FL ME133344) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: KY TP193) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN20076) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2023-12-08 |