| NPI | 1194763789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 052821) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 052821) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-04-30 |