| NPI | 1053739888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2022035782) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-46289) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2025-11-12 |