| NPI | 1366769879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.124264) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.124264) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.124264) | |
| 208M00000X Hospitalist (Licence: OK 35.124264) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2024-05-16 |