| NPI | 1649477365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 79991) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 2080P0202X) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036.125647) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2025-10-07 |