| NPI | 1811067291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NV 16395) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 22480) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-03-09 |