| NPI | 1205369295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A173283) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A173283) |
| 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CA A173283) | |
| 208000000X Pediatrics (Licence: NC 2020-02871) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2026-04-24 |