| NPI | 1366947012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 66102) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 29188) |
| 208000000X Pediatrics (Licence: MN 66102) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-10-14 |