| NPI | 1568480093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: AZ 37217) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 37217) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2001014677) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-02-06 |