| NPI | 1760437891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301108861) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301108861) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2012-01960) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-05-12 |