| NPI | 1700272739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 79595) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 278901) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 79595) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-10-30 |