| NPI | 1053637850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2017-02086) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2017-02086) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2024-07-15 |