| NPI | 1578750949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 56333) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A101374) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2018-06-01 |