| NPI | 1316213028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.136903) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.136903) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2025-04-22 |