| NPI | 1174555957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: KS 04-29123) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MO 2001016013) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-10-02 |