| NPI | 1811911530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35098178) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 46434) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-07-27 |