| NPI | 1669543856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 059459) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200401529) |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2023-03-07 |