| NPI | 1790893659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 22743) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 22743) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2017-10-24 |