| NPI | 1013168418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.094816) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.015048) |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2025-06-23 |