| NPI | 1841558657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A155240) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A155240) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2020-04-13 |