| NPI | 1972645984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.088185) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 46595) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-07-21 |