| NPI | 1902007081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD428254)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD428254)  | 
| Enumeration Date | 2007-05-29 | 
| Last Update Date | 2014-12-05 |