| NPI | 1639133952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD445998) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 052495) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2023-01-27 |