| NPI | 1134771702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: IA MD-49533) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351044256) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2022-05-31 |