| NPI | 1821032830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35-099480) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD.15508R) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2012-10-15 |