NPI | 1588210157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OR 185737) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OR 185737) |
Enumeration Date | 2019-08-09 |
Last Update Date | 2019-10-30 |