| NPI | 1306939608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101277458) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101277458) |
| 208000000X Pediatrics (Licence: MD D69103) | |
| 208000000X Pediatrics (Licence: VA 0101277458) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35080991) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D69103) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-08-11 |