| NPI | 1457410813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: OH 35.123621) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 230329) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2014-06-19 |