| NPI | 1326241035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WV 25178) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 33007) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-12-09 |