| NPI | 1710191630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.095128) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH none) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-03-10 |