| NPI | 1083095269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL 157342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 52108) |
| 208M00000X Hospitalist (Licence: SC MD52108) | |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2023-09-15 |