| NPI | 1184912248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: OH 123551) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011017909) | 
| Enumeration Date | 2011-07-11 | 
| Last Update Date | 2022-07-21 |