| NPI | 1043516735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 316270) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: NY 316270) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.133440) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.133440) | |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2026-04-09 |