| NPI | 1740773811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A171867) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT215124) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2021-04-12 |