| NPI | 1124135454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NM MD2020-0088) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO R9H67) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-02-27 |