| NPI | 1366705659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-127201) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-127201) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-10-12 |