| NPI | 1174574107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 44951) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 44951) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35-04-36022) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2018-12-05 |