| NPI | 1740675909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: OH 35.130813) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.026377) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2022-06-29 |