| 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 | 2022-05-02 |