| NPI | 1457636235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD472947) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122002) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.122002) | |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2021-06-29 |