| NPI | 1861500811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WV 26675) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 19928) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35122446) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-07-21 |