| NPI | 1568412377 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2003000631) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MO 2003000631) | 
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: KS 04-29903) | |
| 208000000X Pediatrics (Licence: KS 04-29903) | |
| Enumeration Date | 2006-05-11 | 
| Last Update Date | 2016-02-09 |