| NPI | 1649257569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: OK 16192) | 
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OK 16192) | 
| 208000000X Pediatrics (Licence: OK 16192) | |
| Enumeration Date | 2005-12-30 | 
| Last Update Date | 2007-10-27 |