| NPI | 1205883899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-073387) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35073387F) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2011-07-26 |