| NPI | 1831306851 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.093256) | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 46317) | 
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IN 01072809a) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WV 25416) | |
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2022-07-21 |