| NPI | 1003426412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD-56373) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.248860) |
| 208000000X Pediatrics (Licence: IA MD-56373) | |
| 208000000X Pediatrics (Licence: AR E-16928) | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2026-07-15 |