| NPI | 1568813798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 331552) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 331552) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2022-06-14 |