| NPI | 1184286270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2022025583) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 05-51694) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-09-15 |