| NPI | 1255373049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 331614) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME86455) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ME 015546) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2026-04-28 |