| NPI | 1639674724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2024029047) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: KS 04-49700) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-08-08 |