| NPI | 1568659134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A90576) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD60087316) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 050859) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2020-05-29 |