| NPI | 1669889507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 3571) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 119077) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-08-30 |