| NPI | 1548420292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2018016256) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NV 14233) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-08-21 |