| NPI | 1093246902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX V8476) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 34.014338) |
| 208000000X Pediatrics (Licence: OH 34.014338) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-09-23 |