| NPI | 1215383716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NE 34649) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 218126) |
| 208000000X Pediatrics (Licence: MO 2019024418) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2025-12-09 |