| NPI | 1245258920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MI 4301503589) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 108179) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 108179) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-03-01 |