| NPI | 1790755502 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: AZ 42956) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: UT 182353-1205) | 
| Enumeration Date | 2006-01-24 | 
| Last Update Date | 2013-01-11 |