| NPI | 1003376435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT228954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.147502) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2023-06-19 |