| NPI | 1174779664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME181516) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 52709) |
| 208000000X Pediatrics (Licence: IL 125049669) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2026-06-17 |