| NPI | 1629056973 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: SC 30573) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 48012) | 
| Enumeration Date | 2006-01-06 | 
| Last Update Date | 2020-11-04 |