| NPI | 1962793422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: NC 2014-00498) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 173590) |
| 208000000X Pediatrics (Licence: NC 2014-00498) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2022-12-08 |