| NPI | 1740217124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PR 10625) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: VA 42400) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2013-03-12 |