| NPI | 1699861187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 64196) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A87113) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 64196) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2021-02-18 |