| NPI | 1124859392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 80458) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 34364) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-07-31 |