| NPI | 1801974951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OH 35012599Z) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: GA 074171) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-08-08 |