| NPI | 1417697632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.153487) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL87997) |
| 208M00000X Hospitalist (Licence: OH 35.153487) | |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-05-19 |