| NPI | 1285620203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.073196) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.073196) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P7402) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2026-07-06 |