| 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 |