| NPI | 1407146947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A124924) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A124924) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2020-05-19 |