| NPI | 1649226986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SD 4079) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 35917) |
| 208000000X Pediatrics (Licence: MN 47589) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-03-31 |