| NPI | 1912997982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35073275) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35073275) |
| 208000000X Pediatrics (Licence: OH 35073275) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2025-10-03 |