| NPI | 1225290711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01067769A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.013903) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2021-02-02 |