| NPI | 1962791269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.120581) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35120581) |
| 208000000X Pediatrics (Licence: OH 35120581) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35120581) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2023-08-04 |