| NPI | 1700910114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C129861) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C129861) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 5174504-1205) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-04-11 |