| NPI | 1598788556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101268182) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: LA 13558R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-09-23 |