NPI | 1629411970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 72902) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD61213463) |
Enumeration Date | 2013-04-16 |
Last Update Date | 2022-12-15 |