| NPI | 1235513284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 62598) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 100314) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 62598) | |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2023-02-21 |