| NPI | 1003172248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 338078) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 26702) |
| 208000000X Pediatrics (Licence: LA 338078) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2023-09-22 |