| NPI | 1811220957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: LA 325077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 261269) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2023-01-09 |