| NPI | 1346213196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 18384) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK 2018) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AK 2018) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2022-12-12 |