NPI | 1376821512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-136677) |
Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: OH 35-136677) |
208M00000X Hospitalist (Licence: OH 35-136677) | |
Enumeration Date | 2011-07-21 |
Last Update Date | 2025-05-19 |