| NPI | 1508327552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35144556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35144556) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2023-05-03 |