| NPI | 1811967185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.071705) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35071705) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2025-05-19 |