| NPI | 1972589968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2009039681) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 237324) |
| 208000000X Pediatrics (Licence: OH 35.088489) | |
| 208M00000X Hospitalist (Licence: OH 35.088489) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2023-11-07 |