| NPI | 1891056982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: MN 55014) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 55014) |
| 208000000X Pediatrics (Licence: SD 9316) | |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: SD 9316) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2021-05-19 |