| NPI | 1730409046 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2018-00853) | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2018-00853) | 
| Enumeration Date | 2010-06-09 | 
| Last Update Date | 2024-07-19 |