| NPI | 1558574400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.133442) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2010005087) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2010005087) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2018-06-06 |