| NPI | 1417222472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A120119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A120119) |
| 208000000X Pediatrics (Licence: CA A120119) | |
| Enumeration Date | 2012-03-09 |
| Last Update Date | 2022-07-21 |