| NPI | 1265425177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI JD063672) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2026-06-01 |