| NPI | 1033233192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OR MD29308) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301080000) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD60095370) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2026-03-06 |