| NPI | 1053302992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 52686) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 217260) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 52686) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2022-02-18 |