| NPI | 1578069852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34-015208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34-015208) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2022-02-11 |