| NPI | 1215995956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301087737) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.143876) |
| 208000000X Pediatrics (Licence: MI 4301087737) | |
| 208000000X Pediatrics (Licence: MA 223391) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.143876) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OH 35.143876) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-12-15 |