| NPI | 1073176657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 73878-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 73878-20) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2025-06-06 |