| NPI | 1821388844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.133593) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301119111) |
| 208000000X Pediatrics (Licence: OH 35.133593) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301119111) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2025-04-22 |