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 |