| NPI | 1578500252 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 82595) | 
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: OH 82595) | 
| Enumeration Date | 2006-06-01 | 
| Last Update Date | 2012-05-31 |