| NPI | 1811968134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 53613) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA04207500) |
| 2080P0205X Pediatrics Pediatric Endocrinology (Licence: TN 56313) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2024-01-10 |