| NPI | 1013302090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 34.013727) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34013727) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34013727) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-02-13 |