| NPI | 1710004817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 201100748) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2011-00748) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-01-25 |