| NPI | 1215057765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 0437840) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D72554) |
| 174400000X Specialist (Licence: VA 0101249504) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D72554) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101249504) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2015-03-03 |