| NPI | 1750039186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A209715) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A209715) |
| 208000000X Pediatrics (Licence: IL 125.081346) | |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2026-07-06 |