| NPI | 1134328537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.097530) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MA 232920) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2016-05-23 |