| NPI | 1952395584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD-42980) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 204838) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35-062950) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2015-12-31 |