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 |