| NPI | 1760864441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.133386) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT209565) |
| 208000000X Pediatrics (Licence: OH 35.133386) | |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2023-10-12 |