| NPI | 1235446865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 14198) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ND 14198) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2023-07-10 |