| NPI | 1508065186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 29962) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL29962) |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2020-10-08 |