| NPI | 1275829749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR.0060218) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 59002) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-01-13 |