| NPI | 1770506057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101248897) |
| Additional Taxonomies | 2080I0007X Pediatrics, Clinical & Laboratory Immunology (Licence: VA 0101248897) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 39798) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-11-02 |