| NPI | 1922525138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.151353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.151353) |
| 208000000X Pediatrics (Licence: MI 4301511022) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2024-09-04 |