| NPI | 1962066035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A181965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10066878) |
| 208000000X Pediatrics (Licence: CA A181965) | |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2025-05-29 |