| NPI | 1861719213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.122535) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122535) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35122535) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2023-11-03 |