| NPI | 1003814856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-41634) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2014006064) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2019-01-18 |