| NPI | 1790139962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD480023) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD047114) |
| 208000000X Pediatrics (Licence: PA MD480023) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-02-23 |