| NPI | 1891738530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics Pediatric Endocrinology (Licence: CA 48500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 48500) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-04-16 |