| NPI | 1174575559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35074518) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35074518) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-12-08 |