| NPI | 1285648899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ND 11789) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 48652) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 48652) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2026-10-12 |