| NPI | 1619208980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72204) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MI 4301108745) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 70530) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2024-01-03 |