| NPI | 1003914490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 36777) |
| Additional Taxonomies | 2080P0205X Pediatrics Pediatric Endocrinology (Licence: OH 000500) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-03-07 |