| NPI | 1023423852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2025-00900) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2025-00900) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2025-09-25 |