| NPI | 1700203809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35127410) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-127410) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-127410) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-02-15 |