| NPI | 1750812202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35141682) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35141682) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: OH 35141682) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-04-10 |