| 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 |