| NPI | 1689804148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL OS12263) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2009-00526) |
| Enumeration Date | 2009-07-19 |
| Last Update Date | 2024-06-27 |