| NPI | 1811263825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MO 2018013517) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2018013517) |
| 208000000X Pediatrics (Licence: MO 2018013517) | |
| Enumeration Date | 2012-03-24 |
| Last Update Date | 2025-04-17 |