| NPI | 1821520230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: UT 13293976-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35138895) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35138895) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2024-03-06 |