| NPI | 1104408038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 34017488) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34.017488) |
| 208M00000X Hospitalist (Licence: OH 34017488) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2025-09-11 |