| NPI | 1316357338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: OH 34-012666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34-012666) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34-012666) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2022-11-23 |