| NPI | 1609971290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CA A77508) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2005021812) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-05-12 |