| NPI | 1588059349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2022026317) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-46173) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2026-03-06 |