| NPI | 1609266774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35140458) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35140458) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2025-05-19 |