| NPI | 1073999843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.133861) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.133861) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2026-05-15 |