| NPI | 1629502455 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME144730) | 
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: FL ME144730) | 
| Enumeration Date | 2017-04-18 | 
| Last Update Date | 2023-08-09 |