| NPI | 1164886750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: OH 35.135689) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 62591) |
| 208000000X Pediatrics (Licence: OH 35.135689) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-08-29 |