| NPI | 1356654867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 56039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R72275) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 56039) | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2018-08-29 |