| NPI | 1396087136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics Pediatric Endocrinology (Licence: OH 35.133162) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A140347) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2022-09-26 |