| NPI | 1740773811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: VA 0101281829) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A171867) | 
| 208000000X Pediatrics (Licence: PA MT215124) | |
| Enumeration Date | 2018-06-12 | 
| Last Update Date | 2024-12-02 |