| NPI | 1134147572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO R3G58) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO R3G58) |
| 2086S0120X Surgery Pediatric Surgery (Licence: MO R3G58) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-04-25 |