| NPI | 1245866243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 68957) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML61059964) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-07-17 |