| NPI | 1215595376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34.015592) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.015592) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2024-02-20 |