| NPI | 1568552065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 38516) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 63123) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 32079) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AR E-4154) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-01-12 |