| NPI | 1689808057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 62345) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013017444) |
| 208000000X Pediatrics (Licence: KS 04-38923) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-38923) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2013017444) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2020-11-10 |