| NPI | 1497014922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 94737) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.140501) |
| 208000000X Pediatrics (Licence: OH 35.140501) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-06-15 |