| NPI | 1861697757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WV 35793) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.095043) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2025-07-21 |