| NPI | 1669569695 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35-071218)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-071218)  | 
| Enumeration Date | 2006-10-10 | 
| Last Update Date | 2014-08-14 |