| NPI | 1376049189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0073239) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.141741) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-02-05 |