| NPI | 1356514624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A112611) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A112611) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 261363) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2021-04-08 |