| NPI | 1700468261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35.150661) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.150661) |
| 208000000X Pediatrics (Licence: OH 35.150661) | |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2026-05-15 |