| NPI | 1982950937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35130417) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35130417) |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: MS 27217) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2021-10-13 |