| NPI | 1427107598 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD00045351) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00045351) | 
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WA MD00045351) | |
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2024-08-07 |