| NPI | 1659946267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT222369) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT222369) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2024-06-04 |