| NPI | 1831119502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NC 2021-01567) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: VA 0101235985) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-10-29 |