| NPI | 1043705809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.141393) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301114935) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-06-11 |