| NPI | 1598746620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 209708) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 209708) |
| 208000000X Pediatrics (Licence: MA 209708) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-07-19 |