| NPI | 1740543396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: TX SO561) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S0561) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2025-07-17 |