| NPI | 1588920904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: WA 60824881) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: WA 60824881) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2020-01-06 |