| NPI | 1922102359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics Pediatric Endocrinology (Licence: TX R5392) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R5392) |
| 208000000X Pediatrics (Licence: VA 0101238171) | |
| 2080P0205X Pediatrics Pediatric Endocrinology (Licence: VA 0101238171) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-03-27 |