| NPI | 1194761312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA md00046508) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA md00046505) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D72813) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD461166) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-08-02 |