| NPI | 1114314267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-138842) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-138842) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-02-01 |