| NPI | 1801868658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C129462) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD426904) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME126009) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2022-06-23 |