| NPI | 1245643121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.132761) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116026789) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR.0066253) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-08-17 |