| NPI | 1306076252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 60073) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD P23945) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2019-12-09 |