| NPI | 1205219078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35142481) |
| Additional Taxonomies | 2080H0002X (Licence: OH 35142481) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2023-02-16 |