| NPI | 1629360250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NC 254794) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 254794) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2020-01-23 |