| NPI | 1053559559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 65042) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036128233) |
| 208000000X Pediatrics (Licence: IL 036128233) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036128233) | |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2025-03-04 |