NPI | 1104043710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 84600) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA 41078) |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 51840) | |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 41078) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2024-11-05 |