| NPI | 1265662241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2012026129) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012026129) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2012026129) | |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2018-03-27 |