| NPI | 1972879070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.126668) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.126668) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2020-09-10 |