| NPI | 1689092462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.014554) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 34.014554) |
| 208000000X Pediatrics (Licence: OH 34.014554) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2026-07-08 |