| NPI | 1023277761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: SC 30988) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL30988) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: SC 30988) | |
| Enumeration Date | 2008-06-07 |
| Last Update Date | 2017-10-24 |