| NPI | 1104097765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.098048) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 45640) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2017-07-27 |