| NPI | 1255869426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME166717) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S6140) |
| 208000000X Pediatrics (Licence: PA MT212744) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2025-02-26 |