| NPI | 1144287871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2010019011) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-086972) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-04-25 |