| NPI | 1093901639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A89930) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CA A89930) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2021-12-15 |