| NPI | 1366983702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 71998) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 86104) |
| Enumeration Date | 2017-03-18 |
| Last Update Date | 2024-10-22 |