| NPI | 1780180604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301518366) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT224901) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2026-07-17 |