| NPI | 1255918629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 79392) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021023745) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-06-13 |