| NPI | 1174542062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WV 16035) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30830) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 30830) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-07-21 |