| NPI | 1639518442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ND 15696) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 58241) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 58241) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-10-28 |