| NPI | 1619260825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35-139248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-139248) |
| 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: OH 35-139248) | |
| 208000000X Pediatrics (Licence: OH 35-139248) | |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2025-04-22 |