| NPI | 1760823801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD60898341) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60898341) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2021-05-20 |