| NPI | 1417319195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL me156543) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0062099) |
| 208000000X Pediatrics (Licence: FL ME156543) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-01-31 |