| NPI | 1265710685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 54174) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA 60757709) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2019-10-30 |