| NPI | 1215376868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 74942) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-063768) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2024-03-11 |