| NPI | 1841389822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: KY 39906) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.084080) |
| 208000000X Pediatrics (Licence: KY 39906) | |
| 174400000X Specialist (Licence: KY 39906) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2024-04-30 |