| NPI | 1639198096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: RI MD19334) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P3581) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P3581) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-06-16 |