| NPI | 1710928759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME90375) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2010-00964) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2010-00964) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2026-02-23 |