| NPI | 1174058036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL 2080P0202X) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301501909) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2025-02-26 |