NPI | 1124249073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C171020) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA C171020) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2021-01-04 |