| NPI | 1639523681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AL MD.42612) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.42612) |
| 208000000X Pediatrics (Licence: OH 35.136760) | |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2021-08-19 |