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 |