| NPI | 1104878990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.057196) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 35401) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-06-20 |