| NPI | 1447578455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME148448) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N5784) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MS 21900) | |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2022-04-04 |