| NPI | 1578525549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35129481) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35129481) |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: OH 35129481) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2020-03-09 |