| NPI | 1629064795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 287050) |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: OH 35086049) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35086049) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2018-10-15 |