| NPI | 1972896157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A130659) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A130659) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2023-11-13 |