| NPI | 1033304696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: SC 34208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M7483) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: TX M7483) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2020-10-14 |