| NPI | 1205255510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME153449) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A138673) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A138673) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-01-07 |