| NPI | 1376930701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: PA MD465105) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD465105) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-03-30 |