| NPI | 1255323440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 35054373) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35054373) |
| 208000000X Pediatrics (Licence: OH 35054373) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2025-04-21 |