| NPI | 1134116494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA G174751) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 44826) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 53605) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2021-12-15 |