| NPI | 1184730889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL 104909) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NM MD2022-1223) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME104909) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2024-01-05 |