| NPI | 1366466633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 36711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301081979) |
| 208000000X Pediatrics (Licence: MI 4301081979) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301081979) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-09-16 |