| NPI | 1306253018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: OH 35.131441) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 131441) |
| 208000000X Pediatrics (Licence: OH 35.131441) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2021-01-06 |