| NPI | 1790280055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35141185) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: OH 35141185) |
| 208M00000X Hospitalist (Licence: OH 35141185) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2023-01-10 |