| NPI | 1619105939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 49591) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.129926) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2017-03-16 |