| NPI | 1003926189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OR DO26736) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA OP00002095) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-07-18 |