| NPI | 1184043325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 12868145-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.132058) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.132058) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-11-01 |