| NPI | 1922251453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.125988) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57-015037) |
| 208000000X Pediatrics (Licence: OH 35.125988) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2018-07-05 |